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AMA/ADA End User License Agreement
LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT® ")

You, your employees and agents are authorized to use CPT only as contained in materials on the Texas Medicaid & Healthcare Partnership (TMHP) website solely for your own personal use in directly participating in healthcare programs administered by THHS. You acknowledge that AMA holds all copyright, trademark and other rights in CPT.

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This product includes CPT which is commercial technical data and/or computer databases and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer databases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.

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EVV Impacts due to Dual Integration Project, Phase II effective Jan. 1, 2027

Last updated on 10/14/2026

On Jan. 1, 2026, the Texas Health and Human Services Commission (HHSC) implemented Phase I of the Integrated Dual Special Needs Plans (Integrated D-SNP) model by discontinuing the Dual Demonstration Program with the Medicare-Medicaid Plans (MMPs) in the demonstration counties listed below:

Bexar County: Molina Healthcare of Texas
Dallas County: Molina Healthcare of Texas and Superior Health Plan
El Paso County: Molina Healthcare of Texas
Harris County: Molina Healthcare of Texas and United Healthcare
Hidalgo County: Molina Healthcare of Texas and Superior Health Plan

MMP members chose a STAR+PLUS managed care organization (MCO) with an Integrated D-SNP in their demonstration county to continue their services.

The table below lists the Integrated D-SNPs implemented on Jan. 1, 2026, the corresponding county, and the plan code.

Plan Name	County	Plan Code
Molina Healthcare of Texas	Bexar	46
Molina Healthcare of Texas	Dallas	9F
Superior Health Plan	Dallas	9H
Molina Healthcare of Texas	El Paso	33
Molina Healthcare of Texas	Harris	7S
United Healthcare Texas	Harris	7R
Molina Healthcare of Texas	Hidalgo	H6
Superior Health Plan	Hidalgo	H5

The model is now in Phase II of implementation which requires the remaining STAR+PLUS MCOs in Bexar, Dallas, El Paso, Harris, and Hidalgo counties to begin operating Integrated D-SNPs on Jan. 1, 2027.

The table below lists the current Integrated D-SNP and the additional STAR+PLUS MCOs, in bold, that will begin operating Integrated D-SNPs on Jan. 1, 2027, the corresponding county, and the plan code.

STAR+PLUS MCO Operating an Integrated D-SNP	County	STAR+PLUS Plan Code
Molina Healthcare of Texas	Bexar	46
Community First Health Plan	Bexar	S1
United Healthcare Texas	Bexar	S5
Molina Healthcare of Texas	Dallas	9F
Health Plan	Dallas	9H
United Healthcare Texas	Dallas	S6
Molina Healthcare of Texas	El Paso	33
El Paso Health	El Paso	S2
Molina Healthcare of Texas	Harris	7S
United Healthcare Texas	Harris	7R
Community Health Choice	Harris	S3
Molina Healthcare of Texas	Hidalgo	H6
Superior Health Plan	Hidalgo	H5
United Healthcare Texas	Hidalgo	S7

STAR+PLUS MCOs are listed in the table and in the HHSC Appendix XXIX, STAR+PLUS Plan Codes and Contract Numbers of the STAR+PLUS Program Support Unit Operational Procedures Handbook.

Payment of Services as of Jan. 1, 2027

Beginning Jan. 1, 2027, dual eligible members may transition to a different MCO operating an Integrated D-SNP.

If dual eligible members transition to a different MCO, program providers, financial management services agencies (FMSAs), and Proprietary System Operators (PSOs) must update the MCO payer plan code in the EVV system for the dual eligible members. In addition, program providers, FMSAs, and PSOs must bill the new payer with dates of service on or after Jan. 1, 2027.

Program providers, FMSAs, and PSOs using a third-party vendor for billing need to notify the third-party vendor about the changes.

Responsibilities of Program Providers, FMSAs, and PSOs: Members Select a Different MCO Operating an Integrated D-SNP

Program providers, FMSAs, and PSOs should continue to use the current authorization in the Electronic Visit Verification (EVV) system for their members through Dec. 31, 2026.

For dates of service beginning Jan. 1, 2027, and after, program providers, FMSAs, and PSOs should:

Identify the STAR+PLUS MCO operating an Integrated D-SNP and the plan code that dual eligible members transitioned to;
Create a new authorization for dual eligible members, using the new STAR+PLUS MCO operating an Integrated D-SNP’s plan code and applicable information from the authorization that ends on Dec. 31, 2026;
Manually enter the dual eligible members new STAR+PLUS authorization into their EVV system.

Program providers, FMSAs, and PSOs can check their dual eligible members’ eligibility and MCO assignment using one of the following methods:

The C21/SAVERR-based TMC EV and 270/271 eligibility inquiry is limited to access only current month eligibility information.
The EaaS/TIERS-based 270/271 or Medicaid Client Portal supports eligibility inquiry for future dates up to the end of the following month. Providers can use this to check eligibility.

Program providers, FMSAs, and PSOs must continue to submit claims with EVV Required services directly to TMHP for EVV claims matching.

HHSC Policy Webinars

STAR+PLUS Policy is hosting the Texas Integrated Dual Eligible Special Needs Plans (D-SNPs) Phase 2 (2027) webinars for members enrolled in Medicare and Medicaid and healthcare providers to learn more about the 2027 expansion.

Member Information Session

Provider Information Session

Resources

Review the Options for Medicare and Medicaid Dual Coverage webpage.
For more information about the Dual Demonstration Transition, email HHSC Managed Care Initiatives.

EVV Impacts due to Dual Integration Project, Phase II effective Jan. 1, 2027

Texas Medicaid Virtual Assistant